PEDRO NOGUEIRA GIGLIO
Projetos de Pesquisa
Unidades Organizacionais
PAHC, Hospital das Clínicas, Faculdade de Medicina - Médico
39 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 39
- Hippocampal plasticity in rats submitted to a gastric restrictive procedure(2011) SONODA, Elisa Yumi de Freitas; SILVA, Sergio Gomes da; ARIDA, Ricardo Mario; GIGLIO, Pedro Nogueira; MARGARIDO, Nelson Fontana; MARTINEZ, Carlos Augusto Real; PANSANI, Aline Priscila; MACIEL, Rude de Souza; CAVALHEIRO, Esper Abrao; SCORZA, Fulvio AlexandreBariatric surgery has been the most effective therapeutic intervention for morbidly obese patients. However, recent evidence has shown that this procedure may cause serious neurological complications such as Wernicke encephalopathy, depression, and memory impairment. With this in mind, we conducted an experimental study to investigate whether weight-reduction surgery would promote morphological changes in the hippocampal formation, a brain region linked to cognitive and emotional processes. To do so, the present study evaluated the hippocampal expression of parvalbumin interneurons in rats submitted to a gastric restrictive procedure (experimental phytobezoar). Our results demonstrated that rats with gastric-reduced capacity presented a significant increase in the expression of the parvalbumin interneurons in the hippocampal CA1 and CA3 subfields. These data are the first experimental evidence that restrictive bariatric surgery may alter hippocampal cytoarchitecture.
- Prevalence and interference of neuropathic pain in the quality of life in patients with knee osteoarthritis(2023) HELITO, Camilo Partezani; MOREIRA, Fernando Sant'Anna; SANTIAGO, Matheus Augusto Maciel; MEDEIROS, Lucas de Faria Barros; GIGLIO, Pedro Nogueira; SILVA, Andre Giardino Moreira da; GOBBI, Riccardo Gomes; PECORA, Jose RicardoObjective: With the aging of the population, more patients have complained of pain due to knee Osteoarthritis (OA), and the number of arthroplasties has also increased. The objective of this study is to evaluate the prevalence of the neuropathic pain component in candidates for Total Knee Replacement and the effects of this component on their quality of life. Methods: In this cross-sectional study, patients with OA candidates for knee arthroplasty in the present institution were evaluated using the pain detection questionnaire and the Visual Analog Pain (VAS) scale to measure the pain index and the presence of associated neuropathic pain. In addition, evaluation of the quality of life and func-tionality using the EQ5D and SF12 questionnaires and their relationship with cases of neuropathic pain were performed. Results: One hundred twenty-six patients were evaluated, and 71.4 % were female. The age ranged from 46 to 85 years, and about 70 % of the patients had some associated clinical comorbidity. Neuropathic pain was present in 28.6 % of the patients evaluated. Patients with neuropathic pain presented worse results in the VAS evaluation, in the care, pain, and anxiety domains of the EQ5D, and in the physical and mental scores of the SF12. Conclusion: Neuropathic pain was present in 28.6 % of the patients with knee OA who are candidates for arthro-plasty. Patients with associated neuropathic pain present a higher level of pain and worse quality of life scores. Recognizing this type of pathology is extremely important in fully monitoring gonarthrosis.
- Combined Reconstruction of the Anterolateral Ligament in Patients With Anterior Cruciate Ligament Injury and Ligamentous Hyperlaxity Leads to Better Clinical Stability and a Lower Failure Rate Than Isolated Anterior Cruciate Ligament Reconstruction(2019) HELITO, Camilo Partezani; SOBRADO, Marcel Faraco; GIGLIO, Pedro Nogueira; BONADIO, Marcelo Batista; PECORA, Jose Ricardo; CAMANHO, Gilberto Luis; DEMANGE, Marco KawamuraPurpose: To compare functional outcomes, residual instability, and rupture rates in patients with ligamentous hyperlaxity undergoing isolated anterior cruciate ligament (ACL) reconstruction or combined ACL and anterolateral ligament (ALL) reconstruction. Methods: Two groups of patients were evaluated and compared retrospectively. Both groups consisted of patients with ACL injuries and associated ligamentous hyperlaxity, defined based on the modified Beighton scale with a minimum score of 5. Group 1 patients underwent anatomical ACL reconstruction, and group 2 patients underwent anatomical ACL reconstruction combined with ALL reconstruction. Group 1 consisted of historical controls. The presence of associated meniscal injury, subjective International Knee Documentation Committee and Lysholm functional scores, KT-1000 measurements, the presence of a residual pivot-shift, and the graft rupture rate were evaluated. The study was performed at University of Sao Paulo in Brazil. Results: Ninety patients undergoing ACL reconstruction with ligamentous hyperlaxity were evaluated. The mean follow up was 29.6 +/- 6.2 months for group 1 and 28.1 +/- 4.2 months for group 2 (P = .51). No significant differences were found between the groups regarding Beighton scale, gender, the duration of injury before reconstruction, follow-up time, preoperative instability, or associated meniscal injuries. The mean age was 29.9 +/- 8.1 years in group 1 and 27.0 +/- 9.1 years in group 2 (P = .017). In the final evaluation, group 2 patients showed better anteroposterior clinical stability as evaluated by KT-1000 arthrometry (P = .02), better rotational stability as evaluated by the pivot-shift test (P = .03) and a lower reconstruction failure rate (21.7% [group 1] vs 3.3% [group 2]; P = .03). Clinical evaluations of postoperative functional scales showed no differences between the 2 groups (P = .27 for International Knee Documentation Committee; P = .41 for Lysholm). Conclusions: Combined ACL and ALL reconstruction in patients with ligamentous hyperlaxity resulted in a lower failure rate and improved knee stability parameters compared to isolated ACL reconstruction. No differences were found in the functional scales.
conferenceObject ONE STEP TECHNIQUETM IS EFFICIENT IN HARVESTING MESENCHYMAL STEM CELLS FROM HUMAN ADIPOSE TISSUE(2021) LEVY, D.; MELLO, L.; GIGLIO, P. N.; CENTURION, P.; VASQUEZ, M. W. M.; LOPES, L. A.; BYDLOWSKI, S. P.; DEMANGE, M. K.- Clinical Outcomes of Posterolateral Complex Reconstruction Performed with a Single Femoral Tunnel(2021) HELITO, Camilo Partezani; SOBRADO, Marcel Faraco; GIGLIO, Pedro Nogueira; BONADIO, Marcelo Batista; PECORA, Jose Ricardo; GOBBI, Riccardo Gomes; CAMANHO, Gilberto Luis; ANGELINI, Fabio JansonThe objective of this study is to report the functional outcomes, complications, and reconstruction failure rate of patients undergoing posterolateral complex reconstruction with a single femoral tunnel technique. Patients with posterolateral complex injuries associated with injury of the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), or both undergoing surgical treatment with the single femoral tunnel technique were included in the study. The International Knee Documentation Committee (IKDC) and Lysholm's scales were evaluated, in addition to age, gender, time between trauma and surgery, trauma type, range of motion (ROM) restrictions, peroneal nerve injury, and reconstruction failure. Sixty-six patients were included. Eighteen underwent ACL and posterolateral complex (PLC) reconstruction (group 1), 24 underwent ACL, PCL, and PLC reconstruction (group 2), and 24 underwent PCL and PLC reconstruction (group 3). The mean follow-up was 63 months. The subjective IKDC was 83.7 +/- 14.6 for group 1, 74.3 +/- 12.6 for group 2, and 66.3 +/- 16.0 for group 3 ( p <0.001). The Lysholm's score was 87.112.8 for group 1, 79.5 +/- 15.0 for group 2, and 77.7 +/- 15.2 for group 3 ( p =0.042). There were six reconstruction failures among the patients (9.1%) with no differences among the groups ( p =0.368). Female gender and reconstruction failure were associated with worse outcomes. Patients undergoing reconstruction of PLC structures with the single femoral tunnel technique achieved good functional outcomes and a failure rate similar to literature. Patients undergoing only combined ACL reconstruction showed better outcomes than patients undergoing combined PCL reconstruction. Female gender was associated with a worse functional outcome irrespective of the injury type.
- Comparison of Floseal (R) and Tranexamic Acid for Bleeding Control after Total Knee Arthroplasty: a Prospective Randomized Study(2019) HELITO, Camilo Partezani; BONADIO, Marcelo Batista; SOBRADO, Marcel Faraco; GIGLIO, Pedro Nogueira; PECORA, Jose Ricardo; CAMANHO, Gilberto Luis; DEMANGE, Marco KawamuraOBJECTIVE: Tranexamic acid (TXA) and the hemostatic agent Floseal (R) have already been used to minimize bleeding during total knee arthroplasty (TKA). METHODS: We conducted a prospective, randomized study of 90 patients with indications for TKA. Following inclusion, the participants were randomly allocated in blocks to the following 3 groups: control, Floseal (R) and TXA. Bleeding parameters, including decreases in hemoglobin (Hb), drain output, number of blood transfusions and complications, were assessed. ClinicalTrials.gov: NCT02152917. RESULTS: The mean decrease in Hb was highest in the control group (4.81 +/- 1.09 g/dL), followed by the Floseal (R) (3.5 +/- 1.03 g/dL) and TXA (3.03 +/- 1.2 g/dL) groups. The Floseal (R) and TXA groups did not differ, and both performed better than the control group. The mean total drain output was 901.3 +/- 695.7 mL in the control group, 546.5 +/- 543.5 mL in the TXA group and 331.2 +/- 278.7 mL in the Floseal (R) group. Both TXA and Floseal (R) had significantly less output than the control group, and Floseal (R) had significantly less output than TXA. The number of blood transfusions was very small in all 3 groups. CONCLUSION: The use of TXA or Floseal (R) was associated with less blood loss than that of the control group among patients undergoing primary TKA, as measured both directly (intraoperative bleeding + drainage) and on the basis of a decrease in Hb, without differences in the rate of complications. TXA and Floseal (R) showed similar decreases in Hb and total measured blood loss, but the drain output was smaller in the Floseal (R) group.
- Regarding ""Intra-articular Injection of Tranexamic Acid Reduced Postoperative Hemarthrosis in Arthroscopic Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Study""(2019) GOBBI, Riccardo Gomes; GIGLIO, Pedro Nogueira; HELITO, Camilo Partezani; PECORA, Jose Ricardo
- Knee arthroplasty with rotating-hinge implant: an option for complex primary cases and revisions(2018) HELITO, Camilo Partezani; GIGLIO, Pedro Nogueira; CAVALHEIRO, Camila Maftoum; GOBBI, Riccardo Gomes; DEMANGE, Marco Kawamura; CAMANHO, Gilberto LuisABSTRACT Objective: To present the indications, technical aspects, and initial results of the first cases using Endo-Model™ implants in Brazil. Methods: A prospective study was conducted. It included nine patients submitted to a total knee arthroplasty, of which six were primary and three were revisions, using exclusively the Endo-Model™ implant. These patients were followed for an average of 12 months and evaluated with functional scores, such as the Knee injury and Osteoarthritis Outcome Score (KOOS), Knee Society Score (KSS), and visual analog pain scale (VAS). Results: There were statistically significant improvements in all scores evaluated in every patient. Only one complication occurred postoperatively (apraxia of the peroneal nerve) and did not require surgery revision. Conclusion: The use of a rotating-hinge implant for knee arthroplasty is a new option for complex cases with severe instability in Brazil; the initial results are satisfactory.
- Surgical Timing Does Not Interfere on Clinical Outcomes in Combined Reconstruction of the Anterior Cruciate Ligament and Anterolateral Ligament: A Comparative Study With Minimum 2-Year Follow-Up(2021) HELITO, Camilo Partezani; SOBRADO, Marcel Faraco; GIGLIO, Pedro Nogueira; BONADIO, Marcelo Batista; PECORA, Jose Ricardo; GOBBI, Riccardo Gomes; CAMANHO, Gilberto LuisPurpose: To compare the functional outcomes, knee stability, failure rate and complication rates of combined anterior cruciate ligament (ACL) and anterolateral ligament (ALL) reconstruction with hamstrings grafts between acute and chronic cases. Methods: Consecutive patients who underwent combined ACL and ALL reconstruction with hamstrings grafts were evaluated. Patients operated on less than 8 weeks after injury were allocated to group 1, and the others were allocated to group 2. Demographic data, knee stability, and functional outcomes of the 2 groups were evaluated. Results: Thirty-four patients in the acute group and 96 in the chronic group were evaluated. The follow-up time was similar between the groups (28.7 +/- 5.2 [24-43] months vs 29.4 +/- 7.2 [24-58] months; P = 0.696). No differences were found between the groups in age, sex, trauma mechanism, presence of knee hyperextension, graft diameter, and meniscal injuries. There was no difference between the groups in the postoperative KT-1000 and in the pre- or postoperative pivot shift. The preoperative KT-1000 was higher in group 2 (7.9 +/- 1.1 vs 7.4 +/- 1.2; P = 0.031). There were no differences in the International Knee Documentation Committee or Lysholm. Three (2.3%) patients developed failure, 1 (2.9%) in group 1 and 2 (2.1%) in group 2. The total complication rate was 10% and did not differ between the groups. Conclusions: Combined ACL and ALL reconstruction has similar outcomes in patients undergoing surgery in the acute and chronic phases. Patients with chronic injury have similar knee stability, functional scores, and failure rates as acute-injury patients, and patients with acute injury have no more complications than chronic patients. Level of Evidence: Level III, retrospective comparative therapeutic trial.
- Degenerative Medial Meniscus Tear With a Displaced Flap Into the Meniscotibial Recess and Tibial Peripheral Reactive Bone Edema Presents Good Results With Arthroscopic Surgical Treatment(2021) HELITO, Camilo Partezani; HELITO, Paulo Victor Partezani; SOBRADO, Marcel Faraco; GIGLIO, Pedro Nogueira; GUIMARAES, Tales Mollica; PECORA, Jose Ricardo; GOBBI, Riccardo Gomes; RODRIGUES, Marcelo Bordalo; BERG, Bruno VandePurpose: To report the arthroscopic treatment results of a degenerative medial meniscus tear with a displaced flap into the meniscotibial recess, tibial peripheral reactive bone edema, and focal knee medial pain. As a secondary objective, we propose to identify possible factors associated with a good or poor prognosis of the surgical treatment of this lesion. Methods: From 2012 to 2018, patients who had this specific meniscus pathology and underwent arthroscopic surgical treatment were retrospectively evaluated. Patients with Kellgren-Lawrence (KL) classification greater than 2 were excluded. KL classification, the presence of an Outerbridge grade III/V chondral lesion of the medial compartment, limb alignment, body mass index, and smoking were evaluated. The subjective outcomes included the International Knee Documentation Committee score, improvement in the pain reported by patients, and the Global Perceived Effect (GPE) scale score. Results: A total of 69 patients were evaluated. The mean age was 58.6 +/- 7.1 years. The follow-up time was 48.7 +/- 20.8 months. Fifty-five (79.7%) patients reported pain improvement. The postoperative International Knee Documentation Committee was 62.6 +/- 15.4, and the mean GPE was 2.3 +/- 2.6. Fourteen patients (20.3%) showed no improvement in pain, and 7 patients (10.2%) presented complications. Groups that improved (GPE 0) and did not improve (GPE < 0) did not present differences regarding age, sex, follow-up time, chondral lesions, or body mass index. Patients without improvement had a greater incidence of smoking (P = .001), varus alignment (P = .008), and more advanced KL classification (P < .001). In the multivariate analysis based on the GPE score, KL classification (P = .038) and smoking (P = .003) were significant. Conclusions: Arthroscopic surgical treatment of degenerative medial meniscal tears with a meniscal flap displaced into the meniscotibial recess and adjacent focal bone edema in the tibia shows good results in approximately 80% of cases. Smoking and KL grade 2 were factors associated with poor prognosis of surgical treatment.